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Historical milestones in renal pathology.

Weening JJ, Jennette JC - Virchows Arch. (2012)

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The history of renal pathology can be divided into two eras: one starting with the invention of the microscope and its application to renal tissue; the second with the introduction of the renal biopsy, which coincided with the development of electron microscopy and immunofluorescence microscopy that allowed the analysis of pathological changes in great detail with an eye for pathogenesis and pathophysiology... His multidisciplinary background in clinical chemistry, pathology, and internal medicine provided a unique perspective for making clinicopathologic correlations... He correlated clinical features, associated conditions (e.g., pharyngitis), blood and urine laboratory results, and histologic findings to propose two types of nephritis... Three centuries later, the almost simultaneous development of techniques to safely obtain renal tissue from a patient by means of a percutaneous needle biopsy and to analyze the tissue not only by light microscopy but also by electron microscopy and immunofluorescence microscopy suddenly provided the structural basis for diagnosis of the many different inflammatory and non-inflammatory, acute and chronic, relapsing and remitting, proteinuric and hematuric, hypertensive and non-hypertensive, and all other renal diseases that had been impossible to classify in an orderly fashion thus far... The renal needle biopsy was first used for clinical diagnosis of patients by Nils Alwall from Lund, Sweden in 1944... Alwall was successful in obtaining renal tissue by an aspiration technique from his first 13 patients but when 1 of them died from complications, he decided to no longer pursue the technique and did not publish his work until 1952... The pathology world was at first skeptical, or should we say hostile, to the idea of a tiny renal biopsy on which a full diagnosis was supposed to be made (“the smaller the biopsy, the more they want to know” is a frequently heard complaint in the practice of pathology)... But several pathologists took up the challenge and successfully collaborated with nephrologists to advance the field of nephropathology... With the advent of the renal biopsy, and the application of better histology methods and electron microscopy, the understanding of the histopathology of renal disease developed rapidly at many centers around the world... Between 1970 and 2010, etiology, pathogenesis, clinicopathological correlations, and classification were established for renal diseases as diverse as lupus nephritis, post-infectious glomerulonephritis, multiple forms of membranoproliferative glomerulonephritis, anti-GBM disease, membranous glomerulopathy, IgA nephropathy, ANCA-associated vasculitis and glomerulonephritis, focal segmental glomerulosclerosis and other podocytopathies, hereditary renal diseases, hemolytic uremic syndrome, tubulointerstitial disease, renal injury in the kidney transplant patient, and many others (Table 1)... Today’s renal pathologists continue to build on the strong foundation laid by the pioneers of renal pathology to advance our knowledge of the pathology and pathogenesis of kidney diseases and to use this to improve the management of patients... In the almost 100 years since the pioneering clinicopathologic studies of Volhard the internist and Fahr the pathologist, tremendous advances have been made in our understanding of the pathology and pathophysiology of kidney disease and the care of patients with kidney disease... These advances have come as a result of intense collaboration between nephrologists and nephropathologists and have been facilitated by sharing new knowledge disseminated through national and international scientific societies, journals, and annual congresses in the field of pathology and nephrology... Advances in renal pathology also have been fostered in particular by the vitality of the Renal Pathology Society, which is international, and the Nephropathology Working Group of the European Society of Pathology... International collaborative efforts to benefit from advances in nephropathology have not been confined to economically well-off countries but also have been extended to the developing countries through the International Society of Nephrology.

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Giovanni Baptista Morgagni’s major work “DE SEDIBUS ET CAUSIS MORBORUM” (Ed. Venice, 1762). From the Bibliotheca Accademia Pugliese, Italy
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Fig2: Giovanni Baptista Morgagni’s major work “DE SEDIBUS ET CAUSIS MORBORUM” (Ed. Venice, 1762). From the Bibliotheca Accademia Pugliese, Italy

Mentions: In spite of the seminal contributions of Malpighi based on the use of the microscope, his findings were completely overlooked by Giovanni Battista Morgagni who is regarded as the father of pathological anatomy. Morgagni was born in 1682 and lived and worked immediately after Malpighi, who had died in 1694. Morgagni was an anatomist and clinician and related postmortem findings to his clinical observations. He performed over 600 autopsies that form the basis for his major work De Sedibus et causis morborum per anatomem indagatis that was published in 1761 (Fig. 2) and had many reprints throughout Europe [2]. However, a complete understanding of the various diseases described in this book including those of the kidneys failed because of a lack of microscopic analysis, which Morgagni refused to rely on as an important tool.Fig. 2


Historical milestones in renal pathology.

Weening JJ, Jennette JC - Virchows Arch. (2012)

Giovanni Baptista Morgagni’s major work “DE SEDIBUS ET CAUSIS MORBORUM” (Ed. Venice, 1762). From the Bibliotheca Accademia Pugliese, Italy
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3400763&req=5

Fig2: Giovanni Baptista Morgagni’s major work “DE SEDIBUS ET CAUSIS MORBORUM” (Ed. Venice, 1762). From the Bibliotheca Accademia Pugliese, Italy
Mentions: In spite of the seminal contributions of Malpighi based on the use of the microscope, his findings were completely overlooked by Giovanni Battista Morgagni who is regarded as the father of pathological anatomy. Morgagni was born in 1682 and lived and worked immediately after Malpighi, who had died in 1694. Morgagni was an anatomist and clinician and related postmortem findings to his clinical observations. He performed over 600 autopsies that form the basis for his major work De Sedibus et causis morborum per anatomem indagatis that was published in 1761 (Fig. 2) and had many reprints throughout Europe [2]. However, a complete understanding of the various diseases described in this book including those of the kidneys failed because of a lack of microscopic analysis, which Morgagni refused to rely on as an important tool.Fig. 2

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The history of renal pathology can be divided into two eras: one starting with the invention of the microscope and its application to renal tissue; the second with the introduction of the renal biopsy, which coincided with the development of electron microscopy and immunofluorescence microscopy that allowed the analysis of pathological changes in great detail with an eye for pathogenesis and pathophysiology... His multidisciplinary background in clinical chemistry, pathology, and internal medicine provided a unique perspective for making clinicopathologic correlations... He correlated clinical features, associated conditions (e.g., pharyngitis), blood and urine laboratory results, and histologic findings to propose two types of nephritis... Three centuries later, the almost simultaneous development of techniques to safely obtain renal tissue from a patient by means of a percutaneous needle biopsy and to analyze the tissue not only by light microscopy but also by electron microscopy and immunofluorescence microscopy suddenly provided the structural basis for diagnosis of the many different inflammatory and non-inflammatory, acute and chronic, relapsing and remitting, proteinuric and hematuric, hypertensive and non-hypertensive, and all other renal diseases that had been impossible to classify in an orderly fashion thus far... The renal needle biopsy was first used for clinical diagnosis of patients by Nils Alwall from Lund, Sweden in 1944... Alwall was successful in obtaining renal tissue by an aspiration technique from his first 13 patients but when 1 of them died from complications, he decided to no longer pursue the technique and did not publish his work until 1952... The pathology world was at first skeptical, or should we say hostile, to the idea of a tiny renal biopsy on which a full diagnosis was supposed to be made (“the smaller the biopsy, the more they want to know” is a frequently heard complaint in the practice of pathology)... But several pathologists took up the challenge and successfully collaborated with nephrologists to advance the field of nephropathology... With the advent of the renal biopsy, and the application of better histology methods and electron microscopy, the understanding of the histopathology of renal disease developed rapidly at many centers around the world... Between 1970 and 2010, etiology, pathogenesis, clinicopathological correlations, and classification were established for renal diseases as diverse as lupus nephritis, post-infectious glomerulonephritis, multiple forms of membranoproliferative glomerulonephritis, anti-GBM disease, membranous glomerulopathy, IgA nephropathy, ANCA-associated vasculitis and glomerulonephritis, focal segmental glomerulosclerosis and other podocytopathies, hereditary renal diseases, hemolytic uremic syndrome, tubulointerstitial disease, renal injury in the kidney transplant patient, and many others (Table 1)... Today’s renal pathologists continue to build on the strong foundation laid by the pioneers of renal pathology to advance our knowledge of the pathology and pathogenesis of kidney diseases and to use this to improve the management of patients... In the almost 100 years since the pioneering clinicopathologic studies of Volhard the internist and Fahr the pathologist, tremendous advances have been made in our understanding of the pathology and pathophysiology of kidney disease and the care of patients with kidney disease... These advances have come as a result of intense collaboration between nephrologists and nephropathologists and have been facilitated by sharing new knowledge disseminated through national and international scientific societies, journals, and annual congresses in the field of pathology and nephrology... Advances in renal pathology also have been fostered in particular by the vitality of the Renal Pathology Society, which is international, and the Nephropathology Working Group of the European Society of Pathology... International collaborative efforts to benefit from advances in nephropathology have not been confined to economically well-off countries but also have been extended to the developing countries through the International Society of Nephrology.

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